KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Secret Sauce In Maine's Successful High-Risk Pool: Enough Money

Before the Affordable Care Act’s exchanges began, Maine had an “invisible high-risk pool” in place. Republican lawmakers are pointing to it as a success — but it was better funded by a vast margin than the high-risk pools in the House replacement bill. (Patty Wight, Maine Public, 5/17)

Political Cartoon: 'Go With The Floe?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Go With The Floe?'" by Lee Judge, The Kansas City Star.

Here's today's health policy haiku:

THE STORY CONTINUES: REP. CHRIS COLLINS AND AN AUSSIE BIOTECH FIRM

Was this deal fishy?
That’s what the ethics office
Really wants to know.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Health Law

Who's To Blame For Premium Spikes This Year? Well, There's Enough To Go Around

Insurers are still trying to overcome financial difficulties they've had under the Affordable Care Act, but uncertainty on the future of the marketplace due to turmoil in Washington, D.C., hasn't helped either. Meanwhile, even if President Donald Trump follows through on his threats to stop the "insurer bailouts," it could actually make plans more affordable.

The Associated Press: More Health Insurance Woes Looming: Blame Trump Or Obama?
Another year of big premium increases and dwindling choice is looking like a distinct possibility for many consumers who buy their own health insurance — but why, and who’s to blame? President Donald Trump has seized on early market rumbles as validation of his claim that “Obamacare” is a disaster, collapsing of its own weight. Democrats, meanwhile, accuse Trump of “sabotage” on a program he’s disparaged and wants to dismantle. It’s more complicated, say some independent experts. As for blame, there’s enough to go around. (Alonso-Zaldivar, 5/17)

NPR: Trump Plan To End Insurance Subsidies Could Lower Costs For Consumers
President Trump has been saying in recent weeks that the Affordable Care act, or Obamacare, is "dead." So he's threatened to cut off crucial payments to health insurance companies that help low-income customers pay day to day health care expenses. That plan, however, may just end up bringing more people into the Affordable Care Act insurance markets. (Kodjak, 5/16)

In related news —

Concord (N.H.) Monitor: Despite Uncertainty, All Insurance Companies Want To Return To N.H. Marketplace Next Year
New Hampshire’s health insurance marketplace continues to fare well compared to other states struggling in the face of uncertainties about the future of the Affordable Care Act, since all four companies currently selling policies in New Hampshire have applied to do so again next year. The New Hampshire Insurance Department said in a press release Tuesday that it has received initial filings from insurance companies to offer various medical and dental plans on the 2018 New Hampshire Marketplace on healthcare.gov through the ACA. (Brooks, 5/16)

The Oregonian: Health Insurance Rate Increases For 2018 Submitted To Regulators
Oregonians in the individual insurance market should brace themselves for yet another year of double-digit rate hikes. Eight insurance companies are seeking increases ranging from 6.9 percent to 21.8 percent over 2017. The companies had until Tuesday to submit their 2018 rate requests with the Oregon Insurance Commission. Some consumers will also face dwindling choices for insurance. In Lane, Lincoln and Tillamook counties, just two insurance companies applied to do business in the individual market. (Manning, 5/16)

Bloomberg: Obamacare Insurer Oscar's New Strategy Helps To Narrow Loss 
Oscar Insurance Corp. is starting to stem the bleeding after years of reporting large losses. The privately held health insurer, created to sell plans under the Affordable Care Act, lost $25.8 million across three states in the first three months of this year, compared with a loss of $48.5 million a year earlier, according to regulatory filings Tuesday. The company is beginning to get a handle on its medical costs, as the premiums it collected exceeded what it spent on health services. The Affordable Care Act’s markets for individual health insurance plans have presented challenges for even experienced insurers. (Tracer, 5/16)

A Look At The Senator Leading The Shadow Group Of Moderates Working On Their Own Plan

Sen. Bill Cassidy (R-La.) has extensive background in public health,and he -- along with Sen. Susan Collins (R-Maine) -- also has a plan for a bipartisan measure that looks nothing like the bill that made it through the House.

Stat: Bill Cassidy Has Moderate Ideas On Health Care Reform. Will Anyone Listen?
Bill Cassidy has taught medical students; led efforts to vaccinate thousands of Louisiana schoolchildren; founded a community clinic that pairs uninsured patients with doctors willing to treat them; and after Hurricane Katrina helped to transform an abandoned KMart in Baton Rouge into a makeshift hospital wing. The first-term Republican has effectively spent his career on health care. Now, for the first time in his political life, with Republicans in control of Washington and intent on replacing Obamacare, he’s in a position to play a pivotal role in reforming the nation’s heath care system. (Facher, 5/17)

The Hill: Durbin Okays Dem Meeting With GOP Centrists On ObamaCare 
Sen. Dick Durbin (Ill.), the No. 2 Senate Democrat, said Tuesday it is alright if Democrats talk with two GOP authors of a more centrist Republican plan on healthcare because the pair is looking “beyond repeal.” Democratic leaders said Republicans must drop their efforts to repeal ObamaCare before any bipartisan talks can happen. Some centrist Democrats, though, met with Republicans in a meeting organized by Sens. Susan Collins (R-Maine) and Bill Cassidy (R-La.) on Monday night. (Sullivan, 5/16)

6.3M People With Preexisting Conditions Could Face Higher Premiums Under GOP Health Plan

Republicans say the provision would not affect many people because insurers could only charge patients more if their coverage lapsed for 63 consecutive days. It turns out that's not as rare as it may seem. Meanwhile, Senate Majority Leader Mitch McConnell (R-Ky.) refuses to promise he'll keep the House's tax cuts in the upper chamber's bill, the idea of more generous subsidies is in play, and a look at why Maine's high-risk pool was actually successful while others have failed.

The Hill: Study: 6M With Pre-Existing Conditions Could Be Charged More Under GOP Plan
More than 6 million people with pre-existing conditions could face higher insurance premiums under the GOP’s ObamaCare repeal bill because of gaps in coverage, according to a new analysis by the Kaiser Family Foundation (KFF). Under the American Health Care Act (AHCA), which narrowly passed the House last month, states would be allowed to waive the community rating provision of ObamaCare, which prevents insurers from charging more for those with pre-existing conditions. (Weixel, 5/17)

Bloomberg: McConnell Won't Guarantee All Tax Cuts Stay In Health-Care Bill 
Passing an Obamacare replacement won’t be any easier in the Senate than in the House, Senate Majority Leader Mitch McConnell said Tuesday while refusing to guarantee that his chamber’s plan will keep all of the House bill’s tax cuts. "This is a really tough issue," the Kentucky Republican said in an interview with Bloomberg News. "You all covered extensively the difficulty of getting a bill out of the House. It won’t be any easier getting it out of the Senate." He acknowledged concerns by moderate Republican Susan Collins of Maine and other senators who say the House bill’s tax cuts are too large, but McConnell said he didn’t want to discuss specific approaches as Republicans seek consensus. (Dennis and Litvan, 5/16)

The Hill: Senate GOP Warms To Larger Insurance Subsidies For Older And Low-Income People
Senate Republicans are coalescing around the idea of giving more generous subsidies to lower-income and older people than what’s laid out in the House-passed GOP healthcare reform bill. Many Republicans in the upper chamber generally agree that the skimpier subsidies contained in the House bill need to be beefed up for groups that need more help buying insurance. (Hellmann, 5/17)

Kaiser Health News: Secret Sauce In Maine’s Successful High-Risk Pool: Enough Money
As the GOP health care bill moves from the U.S. House of Representatives to the Senate, many consumers and lawmakers are especially worried that people with preexisting conditions won’t be able to find affordable health coverage. There are a number of strategies under consideration, but one option touted by House Republicans borrows an idea that Maine used just before the Affordable Care Act went into effect. It’s called an “invisible high-risk pool” — invisible because people in it didn’t even know they were.The Maine pool earned higher marks than most state high-risk pools because it had a key ingredient: enough money. (Wight, 5/17)

Montana's Special Election May Be Early Litmus Test For Potential Fallout From Health Care Turmoil

President Donald Trump won the state by 20 points, but will all the shake-up over Republicans' attempts to dismantle the Affordable Care Act sway voters?

NPR: Health Care Bill Relevant In Montana Special Election
Many Democrats are hoping the GOP health care bill that narrowly passed the U.S. House of Representatives is going to push political momentum their way, and result in big gains in the 2018 midterm elections. A special election next week in Montana may be an early test for this theory. President Trump won Montana by 20 points in the November 2016 election, and the May 25 special election is being held to replace the state's only congressman, Rep. Ryan Zinke, whom Trump nominated to be interior secretary. (Whitney, 5/16)

The Hill: Lone GOP Outside Group Offers Cover For GOP Healthcare Vote 
A GOP outside group allied with Speaker Paul Ryan (R-Wis.) is investing further in its effort to provide cover for House Republicans supporting the legislation to reform ObamaCare. American Action Network is to date the only major outside group defending the GOP’s healthcare plan on the airwaves. The advocacy nonprofit has spent more than $3.1 million on ads following the bill’s narrow passage in the House earlier this month, including a new $400,000 wave unveiled Tuesday of radio ads. (Marcos, 5/16)

Nashville Tennessean: Dozens Protest AHCA At Sen. Lamar Alexander's Nashville Home
Moral Movement Tennessee held a candlelight vigil Tuesday outside the West Nashville home of U.S. Sen. Lamar Alexander, R-Tenn. to protest the efforts to dismantle the Affordable Care Act. More than 100 people, many holding signs, gathered for the demonstration at Elmington Park on West End Avenue. The group said the demonstration was organized after they were unable to deliver information about those at risk of losing healthcare access under the AHCA to Sens. Alexander and Bob Corker, R-Tenn., last week. (Sawyer, 5/16)

Morning Consult: Koch Brothers-Aligned Group Launches Ad Knocking ACA Premium Hikes
Freedom Partners, a conservative advocacy group with close ties to the Koch brothers, is launching a new digital advertising push focusing on proposed premium hikes for plans offered through the Affordable Care Act in 2018. The ad, which is airing online this week as Senate Republicans try to craft their own Obamacare replacement legislation, highlights proposed premium hikes in Maryland, Connecticut, Virginia and Washington, D.C. Republicans have branded the proposed rate increases as evidence that Obamacare is failing. (Reid, 5/15)

Veterans' Health Care

Troops Who Have Been Wounded Are Being Discharged For Misconduct At Increasingly High Rate

A Government Accountability Office report finds that the Army often failed to conduct required screenings for post-traumatic stress disorder and traumatic brain injuries before discharging soldiers.

The New York Times: Wounded Troops Discharged For Misconduct Often Had PTSD Or T.B.I.
Three-fifths of troops discharged from the military for misconduct in recent years had a diagnosis of post-traumatic stress disorder, traumatic brain injury or another associated condition, according to a report released Tuesday by the Government Accountability Office. The report, mandated by Congress, for the first time combined military medical and staffing data, as well as data from the Department of Veterans Affairs, to show that tens of thousands of wounded troops were kicked out of the armed forces and severed from benefits designed to ease their transition from service in war. (Philipps, 5/16)

In other veterans' health care news —

The Washington Post: Trump’s Claim Veterans Received ’42 Percent More’ Approvals To Get Non-VA Health Care
The Choice program allows veterans to get health care in the private sector if they face a long wait time or live far from the nearest VA Medical Center. This was a key provision in the August 2014 Veterans Access, Choice and Accountability Act — a bipartisan response to the scandal that erupted over veterans’ delayed access to medical care at VA facilities across the country. Veteran watchdogs have criticized VA for not acting quickly enough to use the appropriated money to improve patients’ access to medical care. Is it true that veterans have received 42 percent more approvals to get non-VA health care through the Choice program? (Lee, 5/17)

Capitol Hill Watch

Health Care Providers Ask Congress To Expand Telemedicine Coverage In Medicare

The group is also seeking permission for Medicare Advantage plans to tailor coverage for some patients with special needs by offering services such as meal delivery for people with diabetes, rides to doctors' appointments and home modifications. Under current law, any add-ons in Medicare Advantage have to be available to all plan members.

Modern Healthcare: Industry Asks Congress For More Leeway On Medicare Advantage, Telemedicine Coverage
Expanding telemedicine coverage and changing rules that govern Medicare Advantage, ACOs and value-based insurance designs would all help improve health and reduce spending on Medicare patients with multiple chronic conditions, said witnesses at a Senate Finance Committee hearing on Tuesday. The Senate's bipartisan Chronic Care Working Group has already gotten six of its policy proposals realized through CMS rulemaking and the 21st Century Cures Act. ... Currently, Medicare reimburses telemedicine only in rural areas and immediate access to care can sometimes make a huge difference. (Lee, 5/16)

CQ HealthBeat: Senate Finance Set To Move Ahead On Bipartisan Medicare Bill
The Senate Finance Committee will mark up on Thursday a bipartisan bill designed to change certain Medicare payment policies to improve the care of people with chronic conditions, such as diabetes. Committee members say they intend to advance the bill this week, although the Senate is immersed in partisan fights over a GOP bid to revise Democrats’ 2010 health care law. The Finance Committee appears on track to approve its Medicare bill (S 870) Thursday, although it’s uncertain what will happen next. Lawmakers could seek to attach the measure, or parts of it, to other bills that face deadlines later this year. These include the renewal of the Children’s Health Insurance Program and the extension of caps on Medicare therapy payments. (Young, 5/16)

In other news from Capitol Hill —

CQ HealthBeat: Republican Appropriator Suggests New Mandatory Health Funding
A top Republican House appropriator suggested Tuesday that a federally funded Native American health program should be reprogrammed from discretionary to mandatory funding. In addition, he said, lawmakers might consider moving it from the Interior-Environment Appropriations bill to the Labor-HHS-Education bill. Oklahoma Rep. Tom Cole, the chairman of the Labor-HHS-Education panel, made the remark at a hearing where tribes raised alarm about proposals to cut fiscal 2018 funding vital to their communities. (Mejdrich, 5/16)

Kaiser Health News: Report: Congressional Ethics Office Probing Rep. Chris Collins’ Aussie Investment
The Office of Congressional Ethics is examining New York Rep. Chris Collins’ role in attracting U.S. investors to an Australian biotech company in which he is the largest shareholder, The Buffalo News reported Tuesday. The story cited unnamed sources who told the newspaper that the office began sending letters to investors seeking information about a month ago. Legally, they are not required to provide it or submit to interviews. (Bluth and Kopp, 5/16)

Administration News

Hundreds Of Doctors Ask Administration To Let Displaced Haitians Stay In U.S.

They came to the United States following the 2010 earthquake. “Haiti reports some of the world’s worst health indicators, which continue to inhibit the country’s development,” the doctors wrote. “These deadly health threats jeopardize the safety and well-being of 50,000 Haitians."

Boston Globe: Hundreds Of Doctors Urge Trump Administration To Allow Haitians With Protected Status To Stay In The Country 
Hundreds of doctors signed a letter Tuesday calling on the Department of Homeland Security to allow about 58,000 Haitians affected by the country’s 2010 earthquake to stay in the United States for at least another year. The letter, signed by 552 doctors from across the country, asked Secretary John F. Kelly to extend their participation in a program known as temporary protected status for another 18 months. (Cramer, 5/16)

In other administration news —

California Healthline: Who Will Care For Abril? Parents Fear For Their Disabled Child If They Are Deported
Every few minutes, Abril begins to choke. Diagnosed as a baby with severe cerebral palsy and epilepsy, the Santa Cruz, Calif., 8-year-old has never spoken, or walked or cleared her own throat. Dozens of times a day, her parents, Rafael and Sonia, use a special machine to suction out saliva and phlegm from their oldest daughter’s mouth. Because choking and seizures can strike Abril anytime, a parent is always by her side. Rafael and Sonia, both from Mexico, have lived in this country without permission for more than a decade. But only since the recent presidential election has a question haunted them: If they are deported, what will happen to Abril? (Wiener, 5/17)

Medicaid

Some States See Opening For Key Medicaid Changes With Trump Administration

At least six states have submitted waiver requests to make significant revisions to their Medicaid programs. Meanwhile, Pennsylvania announced it will expand Medicaid coverage for hepatitis C, and Oregon says it is checking to see if some enrollees got benefits without meeting income requirements for the program.

Governing: 6 States Hoping To Revamp Medicaid In The Trump Era
With Donald Trump in the White House and Tom Price leading the Health and Human Services (HHS) Department, conservative states will likely see their long-denied wishes [to revamp Medicaid] come true. Both officials support giving states more flexibility than the Obama administration, and a final bill to replace the ACA would likely increase states' power as well. So in the early days of the Trump administration, some governors enthusiastically submitted waivers. .... If some of these proposals get the greenlight as expected, they could drastically change the structure of Medicaid in their states and have national implications. These are the six states with planned or submitted waivers worth watching. (Quinn, 5/15)

The Philadelphia Inquirer: In Major Shift, Pa. To Expand Hepatitis C Treatment For Medicaid Patients
Under pressure from advocacy organizations that had threatened a lawsuit, the Wolf administration said Tuesday that it would expand Medicaid coverage for treatment of hepatitis C, a major change that many states have put off over fear of spiraling costs. ... Until now, state policy had been to wait until patients showed signs of liver damage before approving treatment. Allowing earlier treatment was recommended one year ago Wednesday by the department’s Pharmacy and Therapeutics Committee. (Sapatkin, 5/16)

The Oregonian: State Of Oregon Says It May Have Dispensed Millions To Ineligible Medicaid Recipients
The state of Oregon said Tuesday it had dispensed millions of dollars in Medicaid assistance to thousands of Oregonians with no idea whether they were eligible. The Oregon Health Authority says it is working to clarify whether as many as 115,000 Medicaid recipients have incomes low enough to qualify for the benefits they have been receiving. As the Affordable Care Act vastly expanded the Medicaid population in Oregon, the state got approval to skip the normal once-a-year eligibility check on its Medicaid clients. Recipients did qualify initially, agency officials said, but the state failed to check to ensure they still qualified. (Manning, 5/16)

Women’s Health

Administration Reportedly 'Encouraged" Texas To Pursue Millions In Withheld Medicaid Funds

State officials will ask the Trump administration to hand over millions of dollars that the Obama administration withheld because the state cut Planned Parenthood centers from a family planning program.

Dallas Morning News: After Shunning Planned Parenthood, Texas Asks Feds To Reinstate Funding For Women's Health
Texas has long looked to limit the operation and scope of Planned Parenthood, focusing its efforts both on the arm of the organization that performs elective abortions and the one that offers general health care and family planning services. "The state is now testing the current administration to see if they're going to be able to get away with it," said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes. "It really opens up a huge can of worms that could be very destructive." (Mekelburg, 5/15)

Modern Healthcare: Texas' Medicaid Waiver Is A 'Canary In The Coal Mine' For Abortion Carve-Outs
The Trump administration will soon review Texas' proposed plan to regain federal funding for its family planning program that does not include Planned Parenthood or providers that support or perform abortions. If the CMS approves the waiver, other states could seek similar permissions and risk millions losing access to care. Texas lost federal funding for its family planning program known as Healthy Texas Women in 2013 after it stopped reimbursing for services performed at Planned Parenthood. Since then, the program has been totally state-funded. Now facing a $2 billion budget shortfall, Texas is looking for ways to reduce spending. (Dickson, 5/16)

Politico Pro: Texas Request For Family Planning Funds Could Set Trend 
The state's pending request for Medicaid to fund a women's health program that excludes abortion providers will be the first major test of the Trump administration's willingness to let states cut off dollars to Planned Parenthood. Texas' health agency will ask the feds to restore funding for a family planning Medicaid waiver the state dropped six years years ago when the Obama administration insisted states couldn't block abortion providers from their programs. (Rayasam, 5/16)

Meanwhile, in Wyoming -

Casper (Wyo.) Star-Tribune: Wyoming To Lose Only Planned Parenthood Clinic; Casper Location Closes In July
Wyoming’s only Planned Parenthood clinic will close this summer because of financial reasons, the organization confirmed Tuesday. “This is a challenging decision,” said Planned Parenthood of the Rocky Mountains official Adrienne Mansanares. Planned Parenthood’s lone health center in Wyoming is in Casper. It opened in 1975 and serves around 500 patients per year, Mansanares said. It will close July 21. (Rosenfeld, 5/16)

Taking Abortion Pills At Home Just As Safe As In A Clinic, Study Finds

Researchers studied the outcomes of people who turned to Women on Web -- a website that provides counseling and abortion pills online -- for help.

The Associated Press: Study: Taking Abortion Pill At Home As Safe As In A Clinic
Medical abortions done at home with online help and pills sent in the mail appear to be just as safe as those done at a clinic, according to a new study. The research tracked the outcomes of 1,000 women in Ireland and Northern Ireland, who used a website run by a group called Women on Web to get abortion pills. The Netherlands-based nonprofit provides advice and pills to women seeking an early abortion in more than 140 countries where access to abortion is restricted. Ireland and Northern Ireland have some of the world's strictest laws, often only granting approval when a woman's life is at risk. (5/16)

The Washington Post: ‘Internet Abortions’ May Be Option In Some Countries That Restrict The Procedure, Study Suggests
The rate of complications was similar to that of women using the abortion pill with the help of doctors in traditional, face-to-face office settings in countries were abortion is less restricted, the study found. Still, there were some problems. Ninety-three women were referred for further treatment by local doctors because of more severe symptoms, seven needed a blood transfusion, and 26 had to get antibiotics. Researcher Abigail Aiken of the University of Texas at Austin and her collaborators in several other countries concluded that “self sourced medical abortions using online telemedicine can be highly effective, and outcomes compare favorably” with clinical protocols. (Cha, 5/16)

Meanwhile, in the states —

The Associated Press: House Committee Takes Up Bill Protecting Abortion Rights
A state House committee is poised to begin consideration of a bill to ensure abortion remains legal in Delaware if the U.S. Supreme Court ruling in Roe v. Wade is ever overturned. The bill, which narrowly cleared the Senate last week and is up for discussion by House members Wednesday, revises Delaware’s current abortion law, which remains on the books despite being superseded by federal law. (5/17)

Public Health And Education

Test Strips Allow People Using Opioids To Test Their Supply For Fentanyl

The synthetic drug is extremely powerful and is contributing to the high number of overdoses across the country. These kits could help people determine if what they are about to take is stronger than they thought it was. Meanwhile, IBM and MAP Health Management are teaming up to create software to help identify and treat addiction.

NPR: Heroin Test Kits For Purity Are Aimed At Preventing Overdose
In the day room at St. Ann's Corner of Harm Reduction, which runs a needle exchange program in the Bronx, a group of guys are playing dominoes and listening to salsa music while they wait for lunch. And Van Asher, one of the staffers in charge of "transactions" — that means he gives out needles — is talking up his latest idea for how to keep the users here safe. He wants to tell them what's really in their stash. "If you're doing dope," he says to one client, "we'll give you a test strip so you can test and see if there's fentanyl." (Harris, 5/16)

Modern Healthcare: IBM Watson Health, MAP Health Management Join Forces On Addiction Treatment 
IBM Watson Health and MAP Health Management, a population health software maker, have teamed up to create new software that uses cognitive computing to treat long-term addiction and substance abuse. The new version of the MAP Recovery Network platform is driven by IBM's Watson technology, which adds cognitive computing and machine learning to the population health software, allowing it to process unstructured data and to learn as it goes, thereby becoming more and more accurate. (Arndt, 5/16)

And in other news on the opioid epidemic —

Stat: After An Officer's Accidental Overdose, A Police Chief Calls For Stronger Laws
After one of his officers accidentally overdosed during a search and seizure, the police chief of the opioid-besieged town of East Liverpool, Ohio, is calling for stronger penalties for transporting fentanyl and related drugs, and his officers are no longer field testing what they find while on duty. “It’s just too dangerous,” East Liverpool Police Chief John Lane told STAT on Tuesday. “It’s not worth the risk.” It’s been eight months since the town’s opioid crisis made national news, and Lane said very little has changed. Patrolman Chris Green collapsed on Friday after brushing a small amount of white powder from his shirt hours after a field test. (Ross, 5/16)

NPR: HHS Secretary Contradicted Scientific Evidence On Opioid Treatment
Addiction experts are up in arms over remarks by Health and Human Services Secretary Tom Price in which he referred to medication-assisted treatment for addiction as "substituting one opioid for another." Nearly 700 researchers and practitioners sent a letter Monday communicating their criticisms to Price and urging him to "set the record straight." (Harper, 5/16)

Roll Call: Senators Push Back On Trump Drug Abuse Actions
As a presidential candidate, Donald Trump pledged to tackle prescription drug abuse and the flow of illegal drugs into the country. But his White House efforts are off to a rocky start so far. ... while Republican members continue to hold out hope Trump will keep his pledge to combat the opioid epidemic, a number of GOP senators are becoming more vocal in their criticism of his early actions on the issue. “I am alarmed at the defunding [of ONDCP] because that, to me, signals less emphasis on what I think is a deep problem,” West Virginia Sen. Shelley Moore Capito said. “I think we need an overarching policy and I would like to see it remain in the White House where it would get the ultimate attention.” (Williams, 5/16)

The Very Real Possibility Of Making Babies From Skin Cells Offers Tantalizing Hope, Ethical Quandaries

Researchers say in vitro gametogenesis -- creating babies from skin cells -- is only a couple decades away from being possible. That means a gay couple could have a child genetically related to both parents, but it also means someone could for all intents and purposes clone themselves. In other public health news: teens and mental health, maternal age, superbugs in hospitals, knee pain and more.

The New York Times: Babies From Skin Cells? Prospect Is Unsettling To Some Experts
Nearly 40 years after the world was jolted by the birth of the first test-tube baby, a new revolution in reproductive technology is on the horizon — and it promises to be far more controversial than in vitro fertilization ever was. Within a decade or two, researchers say, scientists will likely be able to create a baby from human skin cells that have been coaxed to grow into eggs and sperm and used to create embryos to implant in a womb. (Lewin, 5/16)

USA Today: Empathy Goes A Long Way For Teens Struggling With Mental Health
The opioid epidemic and recent media attention on suicide have put teen mental health under a spotlight, which  raises concerns and questions among parents. The percent of high school students who considered and attempted suicide increased slightly between 2013 and 2015,  federal data show, while the percent of high school students reporting symptoms of depression remained the same. Still, the numbers are startling: One in five teens has a mental health condition. (O'Donnell and Barry, 5/15)

The Associated Press: Women In 30s Now Having More Babies Than Younger Moms In US
For the first time, women in their early 30s are having more babies than younger moms in the United States. Health experts say the shift is due to more women waiting longer to have children and the ongoing drop in the teen birth rate. For more than three decades, women in their late 20s had the highest birth rates, but that changed last year, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention. (Stobbe, 5/17)

Los Angeles Times: UCI Doctor’s Plan To Stop Superbugs Is Widely Used. At Her Own Hospital, It Didn’t Work
By the end of December, a lethal bacterium had swept through UC Irvine Medical Center’s intensive care unit, sickening seven infants. Dr. Susan Huang, the hospital’s infection control expert, had a plan. The strategy — which she had promoted so successfully that most U.S. hospitals now use it — included bathing all infants in the ICU with a powerful disinfectant, and swabbing inside their noses with an antibiotic. (Petersen, 5/16)

The New York Times: Steroid Shots Do Little For Knee Pain Of Arthritis
Doctors often prescribe steroid injections for the pain of knee arthritis, but a rigorous trial has found they work no better than a placebo. Researchers randomly assigned 140 men and women over 45 with painful knee osteoarthritis to injections of either a corticosteroid or a saline placebo. The subjects were injected every three months for two years, with neither the patients nor the people who gave the shots knowing who got the placebo. The study is in JAMA. (Bakalar, 5/16)

The New York Times: Yogurt May Be Good For The Bones
Eating yogurt may lead to stronger bones. Researchers tracked 4,310 Irish adults 60 and older, gathering information on diet and lifestyle with questionnaires. They measured bone density and joint deterioration with X-rays and M.R.I., and tested participants’ physical ability. The study is in Osteoporosis International. (Bakalar, 5/16)

The Washington Post: A Teen Chugged A Latte, A Mountain Dew And An Energy Drink. The Caffeine Binge Led To His Death.
Davis Cripe left home April 26 an active and healthy teenage boy, but in art class that afternoon he fell to his knees and told worried classmates that he felt lightheaded. He passed out on the floor and was rushed to a nearby hospital. By 3:30 p.m., around the time the final bell rang at school, he was dead.His sudden death may have remained a medical mystery, the coroner who conducted his autopsy said, if friends hadn't described what Davis ingested during lunch: Enough caffeine to disrupt and ultimately stop his heart. (Wootson, 5/16)

State Watch

State Highlights: N.Y. State Assembly OKs Single-Payer Bill; Ga. Scrambles To Address Nursing Shortage

Media outlets report on news from New York, Georgia, Massachusetts, Texas, Florida, Illinois, Maryland, California, Minnesota, Wisconsin and Oregon.

The Wall Street Journal: N.Y. Single-Payer Health-Care Bill Passes State Assembly
Democrats in the New York Assembly are relaunching a push for a statewide single-payer health-care program in hopes that the national debate over health care will give their legislation new momentum. The “Medicare-for-all” bill—designed to provide health insurance to all state residents—passed the predominantly Democratic Assembly Tuesday afternoon following several hours of partisan back-and-forth on the chamber floor. (Vilensky, 5/16)

Georgia Health News: Re-Entry Program Brings Former Nurses Back Into The Profession
According to the Georgia Nurses Association, more than 50 percent of the nursing workforce is nearing retirement age. Meanwhile, the aging of the population as a whole means that more nurses and health professionals are needed to act as caregivers. In the Northwest Georgia mountains, Blue Ridge Area Health Education Center (AHEC) is scrambling to relieve the nursing shortage. (Thomas, 5/16)

KXAN: Report: Texas Falling Short On Police Safety During Mental Health Crises 
This investigation involved a 10-month analysis of court and police records, medical histories, media reports and dash and body camera footage, much of it obtained under the Texas Public Information Act. The research revealed shortfalls in police protection statewide: a need for improved mental health training for officers and better communication between law enforcement agencies about potentially violent individuals with mental health issues. (Hinkle and Barer, 5/16)

Orlando Sentinel: Dead Optometry Bill May Be Seen Again
The optometry bill, which for a few weeks reignited the so-called “eyeball wars” between doctors of optometry and doctors of medicine, died in the Legislature this year, but that doesn’t mean the war is over. The state optometry association will decide later this year if it’s going to once again pursue efforts to expand the scope of practice for optometrists in Florida. (Miller, 5/16)

Chicago Tribune: Seniors Seek Affordable Dental Care Options
Like many older people on a fixed income, Ed Slavik knew he couldn't keep up with the high cost of dental care. So a few years ago, the retired school teacher was relieved to find the Dental Division at Stickney Public Health District, where he had fillings and other routine dental work done for free...But public health researchers are hoping to persuade legislators to add a dental benefit to Medicare by highlighting the many seniors forgoing care until their dental health has deteriorated, sometimes causing trouble eating, swallowing or speaking, and igniting other health problems. (Neumann, 5/16)

The Baltimore Sun: State Approves Apprenticeship Program For Hospital Workers 
State officials have approved Maryland's first apprenticeship for environmental care supervisors, who work in hospitals cleaning areas such as surgical rooms...Apprentices will receive technical instruction through the Community College of Baltimore County and be paired with mentors Baltimore-area hospitals. Trainees' wages will increase when they show proficiency in a list of predetermined job functions. Johns Hopkins Hospital will be the first institution to offer the on-the-job training. (Mirabella, 5/16)

Orlando Sentinel: Global Cyberattack Spares Local Health Systems 
The malicious software that quickly spread across six continents last week and locked more than 200,000 computers, including U.K.’s National Health Service, has not affected Central Florida’s two major health systems, officials told the Orlando Sentinel. But their relief is by no means a reassurance for protection from future cyberattacks. (Miller, 5/16)

Sacramento Bee: Botulism Outbreak From Gas Station Nacho Cheese Prompts Lawsuit 
Sacramento County health officials have confirmed five cases of botulism in patients who ate at the Valley Oak Food and Fuel gas station, and are investigating three other probable cases and one suspect case, with all nine patients still hospitalized. Officials believe the outbreak is linked to nacho cheese sauce that was served at the station, but the exact cause of the poisoning is still under investigation, officials said. (Caiola, 5/16)

Pioneer Press: HealthEast, Fairview Merger To Be Completed June 1
The boards of Fairview and HealthEast have approved the merger of the two metro-area hospital systems, and the deal is now expected to be completed June 1, the two organizations announced Tuesday. The combined system will be led by Fairview President and CEO James Hereford. HealthEast CEO Kathryn Correia will join the senior executive team as chief administrative officer. (5/16)

Miami Herald: How Profitable Will Medical-Marijuana Shops Be? Very, Says Confidential Pitch For Investors
A private equity firm’s confidential pitch deck obtained by the Miami Herald shows that only days ago Surterra Florida was seeking investors to buy a $10 million minority stake while also arguing against limits on the number of retail outlets any licensed operator can open. Some potential investors were lured with projections that show Surterra grossing $138 million in sales by 2021 thanks largely to the operation of 55 retail outlets — nearly four times the cap desired by the Florida Senate. (Smiley and Auslen, 5/16)

The Oregonian: Oregon Day Care Closes As Kids Fall Sick After Insecticide Exposure 
A Coos Bay day care center shut down Monday in the aftermath of an insecticide-spraying incident that left at least a half-dozen children and two staff members suffering from inflamed eyes and breathing problems. State regulators opened an inquiry into the May 5 incident but have not sent anyone to visit the Coos Bay Children's Academy Inc., which had an enrollment of about 80 kids. Instead, the owner voluntarily closed the center Monday as several key employees quit and parents pulled children en masse over concerns about transparency and safety. (Schmidt, 5/16)

Prescription Drug Watch

Drugmakers Deploy Lobbyists As Battle Over High Prices Moves To State Level

News outlets report on stories related to pharmaceutical pricing.

The Wall Street Journal: As States Wage Battles On High Drug Prices, Drugmakers Fight Back
Amid increasing calls for curbs on U.S. drug pricing, some of the most aggressive legislative action is happening at the state level—and industry lobbyists are fanning out to fight back. Lawmakers have introduced bills in about 30 state legislatures this year, seeking to regulate drug prices; require manufacturers to justify price increases; or to form purchasing groups with other states to negotiate lower prices, according to the National Academy for State Health Policy, a nonprofit policy group that has drafted model drug-pricing bills for state use. (Loftus, 5/17)

Stat: Can Importing Drugs Bring Down Drug Prices For Americans?
Poll after poll shows Americans are increasingly concerned about the price of prescription drugs. With each new survey, the debate about importing drugs from Canada seems to gain steam. At least four different bills have been introduced this year in Congress, and while the fate of legislation to replace the Affordable Care Act dominates the agenda on Capitol Hill, buying drugs across the border is an idea that won’t go away. (Sheridan, 5/11)

Stat: The 5 Most Overpaid Pharma CEOs In The World
There’s no shortage of ways to rank pharma CEOs: Drug sales. Corporate profits. Even haircuts. Here at STAT, we chose to look at it from a shareholder’s perspective. We calculated shareholder returns over the past three years at the 25 biggest drug companies in the world. Then we compared that with CEO compensation. Five outliers popped out: chief executives who got raises well out of step with what they delivered to investors. (Garde, 5/16)

FiercePharma: The Top 15 Generic Drugmakers By 2016 Revenue
Branded drugmakers weren't the only ones working through a tumultuous 2016. Generics companies faced pricing pressure, too. And while branded companies suffer pricing pain on costly cutting-edge therapies, generics outfits feel the pinch with already-thin margins, making pressure all the more agonizing.How is the industry responding? By consolidating and hoping to save money, for one. Take a look at FiercePharma's 2014 ranking, and it's clear that some companies have made leaps too big to depend on organic growth alone. (Sagonowsky, 5/16)

Stat: Researchers Urge FDA To Lower The Bar On Alzheimer's Drug Approvals
Could changing up regulatory requirements for Alzheimer’s drugs help give desperate patients new options for treatment? A group of researchers and patient advocates think so. They authored a paper that argues that the Food and Drug Administration should evaluate Alzheimer’s drugs for efficacy in either cognition or function — but not both. Efficacy and cognition are the main endpoints measured in Alzheimer’s disease. The hallmark of cognitive impairment is memory loss, while functional impairment involves losing the ability to perform tasks of daily living — from reading to going to the bathroom to getting dressed in the morning. Currently, FDA expects drugs to improve both cognition and function. (Keshavan, 5/15)

NBC News: Patients Beg For Pricey Drugs On Facebook Black Market
Desperate patients are swapping pricey pharmaceutical drugs on Facebook. Doctors say it's dangerous. But when you need a drug every day to survive, you're going to find a way to get it. It shouldn't be that surprising. You can buy, sell or trade almost anything on Facebook, from designer sneakers to unwanted fishing boats to antique medical cots. Now, even life-saving insulin. (Popken, 5/11)

Kansas City Star: 60,000 Older Missourians To Lose Prescription Drug Aid 
Roughly 60,000 older Missourians will lose state aid to help them pay for prescription drugs starting in July. But lawmakers hope the cut won’t be permanent. Seniors who earn less than 85 percent of the federal poverty level, or roughly $10,000 a year for an individual, qualify for both Medicaid and Medicare. (Hancock, 5/11)

Stat: Lower FDA Standards Could Have Cost Billions For Failed Alzheimer's Drug
Priced at $10,000 per person, the cost totaled roughly $10 billion during that time. To some, this would appear to be a bargain for a drug that combats a pernicious disease, yes? But what if it turns out the drug later failed yet another trial and patients with a mild form of Alzheimer’s weren’t helped, after all? The money —much of it spent by Medicare — would have been wasted and patients’ hopes dashed. (Silverman, 5/12)

FiercePharma: EU Officials Question 'Unjustified' Cancer Drug Pricing From Aspen
Upon receiving information that Aspen Pharmacare has taken steep price increases on lifesaving cancer meds in Europe and threatened to pull its products in order to get the hikes through, EU antitrust regulators have pledged to take a close look at the South African drugmaker’s business practices. Europe’s competition authority opened an investigation into Aspen on Monday, seeking to learn whether the company “abused a dominant market position in breach of EU antitrust rules,” according to a release. It noted this is the first time it has looked into excessive pricing in pharmaceuticals. (Sagonowsky, 5/15)

Stat: What Strike? FDA Sees Through Delaying Tactic
That is the lesson that the management at Vikshara Trading & Investments learned the hard way when the company tried to forestall an agency inspection last year by insisting that its workers were on strike and its plant in Gujarat, India, was inaccessible. But were they really on strike?...A year ago, the FDA scheduled an inspection, but last June, Vikshara said employees went on strike and blocked the entrance to the facility. As a result, the agency canceled a planned June 27 inspection. Last July, Vikshara said the strike was ongoing and, in August, provided purported evidence, such as employee resignation letters and a photograph of striking employees blocking the entrance. (Silverman, 5/9)

Stat: Biosimilar Company Uses Citizen's Petition In A New Way
An aspiring biosimilar manufacturer is employing a citizen’s petition in a novel way in hopes of setting regulatory approval standards. In a May 3 letter, Apotex asked the Food and Drug Administration to set a specific requirement for other biosimilar companies that, depending upon what the agency decides, may serve as a barrier to regulatory approval of their treatments. (Silverman, 5/11)

Perspectives: Doctors Are Still Prescribing Brand Name Drugs Over Generics, And You Can Blame Pharma For It

Read recent commentaries about drug-cost issues.

RealClear Health: Why Are Physicians Still Prescribing High Cost Brand Name Drugs? Ask Pharma.
Generic drugs are a boon in health care. Typically lower in cost and as effective as their branded counterparts, they help control pharmacy spending and increase access to important therapies for patients who could be deterred by the high cost of some branded drugs. In fact, research shows that the use of generic drugs produces annual savings in excess of $200 billion. (Troyen Brennan, 5/14)

The Washington Post: Trump’s New FDA Commissioner Has A Huge Decision To Make
Last week, the Senate confirmed Scott Gottlieb to lead the Food and Drug Administration. That puts the new commissioner in the hot seat to tackle several high-profile issues that are critically important to patients and consumers. Among the most important decisions he’ll have to make early on is whether to accept industry proposals to reduce standards under which drugs can be advertised — regulations that have protected patients for more than 50 years. (William B. Schultz, 5/16)

Cincinnati Enquirer: Lowering Prescription Drug Costs Will Improve Care For All Americans
I agree with Gov. John Kasich, we cannot allow Washington politicians with taxpayer-funded health insurance to rip coverage away from Ohioans who are battling cancer, getting regular checkups for the first time, or finally getting treatment for their opioid addiction. Of course we need to do more to lower costs for Ohioans, and I’m ready to work with anyone on commonsense ideas to make our health care system work better. (Sen. Sherrod Brown, 5/25)

Cincinnati Enquirer: Who Represents Us?
Negotiated pricing is the common-sense solution to reining in the costs of prescription drugs. It has been in use for many decades, for drugs bought by the Veterans Administration, General Services Administration, all military branches, and the Defense Supply Center Philadelphia; why not Medicare? There is no acceptable reason for these laws. (James Baker, 5/10)

CNN: Health Care Costs Are Bankrupting Us
The financial insecurity experienced by many Americans certainly figures into any root-cause analysis for why President Trump was elected. But for most Americans, the "biggest tax cut ever" will do little to reduce that insecurity. Driving down health care costs -- and making them more predictable -- is far more important. (H. Gilbert Welch and Elliott Fisher, 5/11)

Bloomberg: Merck Can't Say How Good Its Good News Is
Merck & Co.'s 2017 just got a whole lot brighter. The company announced Wednesday evening that its immune-boosting cancer drug Keytruda can now be prescribed in combination with chemotherapy, vaulting it ahead of its rivals in the space. It's huge news. But exactly how huge it is going forward is largely out of Merck's control. (Max Nisen, 5/11)

The Fiscal Times: How Trump Can Score A Big, Bipartisan Win On Health Care 
Prescription drugs may not be the costliest part of our health system, but they’re the fastest-rising charge that hits individual pocketbooks directly. The demand for legislative reform is palpable; every politician in Washington has an interest in defusing the drug price explosion. But as close as victory sits, it’s also just out of our grasp. (David Dayen, 5/16)

Montana Standard: Three Easy Steps To Drug Price Control
I find it is despicable the House of Representatives is blaming the high cost of health care on the poor, elderly and chronically ill. They need to address the real reasons for increasing costs of health care, the increasing costs of health care. Take drug costs, for starters. The total drug expenditures for 2015 in America rose 12.2 percent during the previous year. (Michael Bernhardt, 5/11)

Editorials And Opinions

Different Takes: Benefits Of Broad Health Reform Consensus; Senate's Path To Crafting Its Repeal-And-Replace Bill

Editorial writers examine different aspects of the current debate surround the GOP repeal-and-replace measure in Congress and the status of Obamacare's marketplaces.

JAMA: Building A Broader Consensus For Health Reform
Republican leaders in Congress are trying to pass legislation rolling back and replacing key features of the Affordable Care Act (ACA) without securing any Democratic support in the effort. ... In political terms, it might be best for Republicans if their effort stalls. The ACA was passed in 2010 with only Democratic votes, and that is a major reason the law remains politically and, to a degree, programmatically unstable. ... It would be better for the United States if a broad consensus could be reached on health care. A bill that passed with support from some Republicans and some Democrats has a better chance of political survival than a bill passed by just one party. It should be possible to reach a broader consensus on health policy because both sides of the debate are forced to work within the significant constraints of existing arrangements. (James C. Capretta, 5/15)

Huffington Post: Hope You Don’t Expect The Senate GOP To Be Transparent About Obamacare Repeal
Senate Republicans have spent the last 10 days or so promising not to tackle health care in the same hurried, irresponsible way that their House counterparts did. “We are not under any deadlines,” Sen. John Cornyn (R-Texas) said last week, “so we are going to take our time.” ... All of that is probably true ― and less meaningful than it sounds at first blush. It’s possible to write a bill in a slower, more deliberative manner than the House did without allowing the kind [of] lengthy, open public debate that legislation of such magnitude would seem to require. It’s also possible to pass less disruptive, less extreme legislation that would nevertheless take away insurance from many millions of people, causing widespread hardship. (Jonathan Cohn, 5/13)

Los Angeles Times: The Costs Of Trump's Sabotage Of Obamacare Already Are Showing Up In Rate Hikes
The easiest prediction to make about the healthcare business was that the efforts by Congress and the Trump administration to sabotage the Affordable Care Act would produce a flood of rate hikes by insurers for 2018. We are now standing on the edge of the water. Early rate requests have come in from insurers in five states, according to ace ACA-tracker Charles Gaba, who calculates the weighted average rate request increase in those states at about 30% (that is, weighted for the enrollment of each insurer). (Michael Hiltzik, 5/16)

Cleveland Plain Dealer: GOP Health Care Reform Plan Could Cripple Ability To Treat Opioid Addiction Victims
At the same moment I was caring for more patients struggling with addiction and its devastating health effects, House Republicans passed the American Health Care Act (AHCA). Sadly, the AHCA would replace President Barack Obama's Affordable Care Act with a law that would end Medicaid expansion and simultaneously make health care more expensive for my most vulnerable patients and reduce important protections for them. (Robert Bonacci, 5/17)

Bloomberg: Cost Of Health Insurance Isn't All About Fairness
Should women have to pay more for health insurance than men? That has been a critical question for opponents of Republican health-care reform, and it requires grappling with the fundamental nature of insurance, market prices and fairness. Related are questions about how much older people should pay relative to the young, or to what extent individuals with pre-existing conditions should be vulnerable to higher premiums. (Tyler Cowen, 5/16)

WBUR: Hey, Millennials: Want To Help The Underserved? Sign Up For Insurance
I often wonder why President Obama, when he was promoting the Affordable Care Act to millennials, didn't bring out a young person like me to help my peers understand why it matters... As politically aware, or "woke" as my peers seem to me, I worry that making the effort to understand and sign up for health insurance is low on people's priority list. (Aditi Juneja, 5/17)

WBUR: Single-Payer Health Care Is The Key To Democratic Victory In 2018 
The Democratic base wants a single-payer system, a slight majority of Independents are warming to the idea and even some conservative voters appear to be growing amenable to cutting insurance companies out of the picture. Thanks to the GOP health care bill's creation and advancement, the Republican Party’s dream of turning American health care over to the private sector is becoming our new, shared reality. (Miles Howard, 5/17)

Viewpoints: Reactions To The Administration's Stepped-Up War On Drugs; The Complexity Of Pending Hearing-Aids Legislation

A selection of public health opinions from around the country.

Lexington Herald-Leader: Paul Right To Reject Failed War On Drugs
The need for criminal justice reform is one of the precious few policy areas that garners widespread bipartisan agreement. Yet, Attorney General Jeff Sessions — a former U.S. attorney and longtime anti-drug crime warrior — reversed an Obama-era policy aimed at keeping non-violent drug offenders out of the federal prison system. Sessions ordered federal prosecutors to charge forward with a policy that has generated enormous human and economic pain with no quantifiable benefits. Kentuckians can be proud that our junior U.S. senator, Rand Paul, called Sessions out on his disastrous decision. (5/16)

The Baltimore Sun: Sessions' Foolish Drug Policy
The War on Drugs has been such an abject failure — the get-tough approach having served to crowd prisons with non-violent offenders who are disproportionately African-American while having little to no discernible impact on actual narcotics use — that the country's elected leaders seemed to have reached a bipartisan consensus in recent years that it was better to focus on prevention and treatment. Prosecutors should throw the book at violent, repeat criminals, but they should not pursue long mandatory, minimum sentences for suspects who don't fit that description. (5/15)

RealClear Health: Over-The-Counter Hearing Aids Legislation Not As Simple As It Seems
One attempted small fix is the Over-the-Counter Hearing Aid Act of 2017 that was introduced on March 21 by Sens. Elizabeth Warren (D-MA), Chuck Grassley (R-IA), Maggie Hassan (D-NH), and Johnny Isakson (R-GA). This bill, which was reported out of the Senate Health Education Labor and Pensions Committee on May 11 — together with a companion measure introduced in the House by Reps. Joe Kennedy III (D-MA) and Marsha Blackburn (R-TN) — has the admirable intent of expanding access to hearing aids for some of the 37.5 million Americans with varying degrees of hearing loss. The bill would for the first time create an over-the-counter (OTC) hearing aid category, allowing the devices to be sold directly to the customer like cheap drug-store eyeglasses. (Andrew Yarrow, 5/17)

The New York Times: If You’re In A Wheelchair, Segregation Lives
Last year, the former chief of the Santa Fe, N.M., police department, Donald Grady II, said something that stuck with me. “There’s a thing that we call freedom of movement,” he said in an interview with The Atlantic, “which is really revered in this country — that we should have the right to move freely without impingement from the police simply because.” He was speaking as both a black man and a police officer about the ways racial discrimination can limit a basic right. But I related to this on more than one level. (Luticha Doucette, 5/17)

Boston Globe: Ambulance Firms Try To Take Insurers For A Ride 
Hope springs eternal on Beacon Hill — and unfortunately, that’s particularly true when it comes to the politically powerful ambulance companies and their desire to leverage higher rates for their services. This year, those companies and their legislative allies are once again hoping to use the budget to advance goals that have otherwise gone nowhere through the more traditional legislative process. (5/17)

Los Angeles Times: Another Way The Rich Get Richer: Study Shows A Widening Gap In Life Expectancy Between Rich And Poor
The United States can take pride in one indisputable marker of racial equality: The gap in life expectancy between the white and black populations has narrowed over time. What was a disparity of more than eight years for Americans born in 1950 has closed to just over three years for those born in 2014, according to actuarial estimates. But let’s not pat ourselves on the back. A different disparity has opened up: The gap in life expectancy between wealthy and low-income Americans is wide and growing wider. And that has implications not only for lifetime health and wealth, but for Social Security. (Michael Hiltzik, 5/16)

The New York Times: Undue Burden: Trying To Get An Abortion In Louisiana
When I set out to make this film in late 2015, the battle over restricting access to abortions in Texas was a national news story. Coverage featured graphs charting the hours women had to drive to find an abortion clinic in the state and maps tracing their paths. Experts weighed in on both sides of a gaping moral divide — politicians made pleas, doctors wrote op-eds. But amid the debate I felt a critical perspective was missing — that of the women across the country who were actually experiencing the effects of these laws. (Gina Pollack, 5/16)